How Common Is Prostate Cancer — and Who Is At Risk?

Prostate cancer is most commonly a problem for men aged 55 to 69. There’s a significant disparity between people diagnosed by prostate cancer and those who’s health and life span are impacted due to the disease. American men face an annual risk of 16 percent of getting prostate cancer but just 2.9 percent who die from prostate cancer.

In reality, many prostate cancers are thought to be growing slowly as men die from other causes that prostate cancer. Studies of autopsy confirm this notion, with one study of 19 autopsy studies concluding that there is a significant increase in undiagnosed prostate cancer in people who are as young as 30 and in over 50% of those over 80.

Certain factors increase the risk of developing prostate cancer These include:

Race African-American men are significantly more likely to be diagnosed with prostate cancer than white men– 203.5 against. 121.9 cancer cases for 100,000 males. Also, they are more than twice as likely white men to die from prostate cancer — 44.1 and. 19.1 mortalities per 100,000.

Family Background A positive family background for prostate cancer is a risk factor in itself.

Obesity Obesity is a different risk factor associated with an increase in the chance of mortality due to prostate cancer and biochemical recurrence among patients with prostate cancer.

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PSA Screening for Prostate Cancer: A Controversial History

The background of the significance that the prostate-specific antigen (PSA) test to diagnose prostate cancer is a source of controversy.

The prostate-specific antibody (PSA) test for blood was first developed in the latter half of the 1980s and it tests for high amounts of antigen. The presence of elevated levels could be a sign for prostate cancer. The test itself isn’t sufficient to determine prostate cancer and was originally thought of as a signpost for prostate cancer the possibility of recurrence or disease progress. However, doctors soon began using it to aid in cancer examinations across in the United States.

Also, in the 1980s, surgeons in both the United States and Europe perfected the procedure for radical prostatectomy that involves the taking out the prostate gland, as well as any cancer inside it. At first, it appeared to be the ideal scenario: men could undergo a straightforward blood test , and prostate cancers that have not been able to spread beyond this gland might be removed.

As time passed there were issues which were not planned for at the time PSA screening was made available:

• PSA may be increased through infections or other effects to the prostate.
• Biopsies were necessary to prove the existence of cancer however it was difficult to differentiate between cancers that could be aggressive and ones that had a slow growth. The majority of prostate cancers had unnecessarily aggressive treatment.
• The issue of overdiagnosis was raised. Patients were being treatment for prostate cancer even when their cancers were slow-growing and not life-threatening.
• The issue of overtreatment was raised. Radial prostatectomy and radiation therapy typically have negative side negative effects, like sexual, urinary, and bowel disorders. This was especially problematic given that many patients with low-grade prostate cancer might not have required these procedures.
• Doctors began to be concerned that these effects could be affecting men’s lives but not helping them live longer.

Current PSA Screening Recommendations

PSA-based screening is the process of testing healthy men with no symptoms.

In the past, medical societies did not agree on screening guidelines however, following the release of the U.S. Preventive Services Task Force Guideline in May 2018, all major medical groups are in agreement with that of American College of Physicians (ACP) as well as ACP, the American Cancer Society (ACS), American Urological Association (AUA) and the American Society of Clinical Oncology (ASCO):

• They also advise men to support them so that they can make an informed decision about screenings which reflect their individual values and preferences.
• Screening routinely is not recommended for men aged between 40 to 54 with normal risk.
• For males between 55 and 69 yearsold, it was the U.S. Preventive Services Task Committee found “with moderate certainty that the net benefit of PSA-based screening … is small for some men, making the decision up to the judgment of the physician and the values of the patient.”
• For men who are 70 years old or over, they advise against routine screening as the risks expected are thought to be greater than the benefits.
• Your doctor should not test you for a condition unless you have expressed an interest in it.
• The discussion on the benefits and drawbacks of screening include the possibility of a familial history of prostate cancer races or other ethnicities, health conditions that impact the overall health and life span, as well as the factors that determine your the risk and benefits.
• If you’re lower than 10 years of time expectancy, screening isn’t advised.

Should Men at Elevated Risk Be Screened More Aggressively?

It may seem reasonable to check for at a younger age for high-risk men or encourage men to lead a healthy way of life to lower their risk of prostate cancer however, these areas aren’t extensively studied. So, doctors’ organizations advocate additional research and individualizing the decision regarding whether or not to undergo a screening. In addition, several leading organizations have issued guidelines for screening, such as:

• The American Urological AssociationThe AUA suggests individualizing decision-making for males less than 55 years old who are at risk due to the fact that their race or ethnicity is african-american or has an ancestral history of positive.
• The U.S. Preventive Services Task Force The USPSTF mostly agrees with AUA’s position. Its 2019 recommendations have been formulated based on the AUA’s evidence-based review.
• The American Cancer Society The ACS takes this step further by urging discussions about screening to begin earlier for African-American men as well as those with relatives of the first degree who have been diagnosed with prostate cancer.